Non-Cochrane · intervention · PM41798445
Clinical Effectiveness and Accuracy of Fully Digital Workflows Versus Conventional Methods in Implant-Supported Restorations: A Systematic Review and Meta-Analysis.
Zailai Abdulaziz, Aldwyyan Nora F, Alsaedy Marwan H, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.102864
Findings
16 findings
| Population | ||||
|---|---|---|---|---|
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Patient-reported comfort and satisfaction (VAS 0-100) | MD 13.98 [-7.74, 35.70] Moderate Downgraded: inconsistency 4 studies · 172 participants |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Sensitivity: leave-one-out, omitting Hashemi et al. [41] | MD -5.43 [-8.86, -1.99] GRADE not reported 5 studies |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Sensitivity: leave-one-out, omitting Corsalini et al. [39] | MD -4.27 [-9.75, 1.20] GRADE not reported 5 studies |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Sensitivity: leave-one-out, omitting Capparè et al. [44] | MD -3.33 [-7.59, 0.93] GRADE not reported 5 studies |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Implant survival (implant failure) 1 to 4 years | RR 1.00 [0.98, 1.02] High 4 studies · 202 participants |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Sensitivity: leave-one-out, omitting Joda and Brägger [47] | MD -4.53 [-9.94, 0.88] GRADE not reported 5 studies |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) | MD -4.28 [-8.40, -0.16] Moderate Downgraded: inconsistency 6 studies · 278 participants |
| Patients receiving implant-supported single crowns, fixed bridges or full-arch prostheses | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Marginal bone loss | mean MBL digital 0.52 mm vs conventional 0.61 mm; not statistically significant GRADE not reported 3 studies |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Sensitivity: leave-one-out, omitting Joda and Brägger [46] | MD -4.49 [-9.92, 0.94] GRADE not reported 5 studies |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Sensitivity: leave-one-out, omitting De Angelis et al. [40] | MD -3.58 [-8.49, 1.32] GRADE not reported 5 studies |
| Patients receiving implant-supported single crowns, fixed bridges or full-arch prostheses | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Biological and prosthetic complication rates | no significant difference in complication rates GRADE not reported Studies not reported |
| Adults with implant-supported restorations (single crowns, short-span bridges or full-arch) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Accuracy/fit (marginal fit or 3D deviation) | SMD 0.20 [-3.72, 4.12] Low Downgraded: imprecision 3 studies · 120 participants |
| Adults with single-implant crowns (subgroup of time efficiency analysis) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Indication: single crown | MD -3.70 [-5.44, -1.96] GRADE not reported 3 studies · 108 participants |
| Patients receiving implant-supported single crowns | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Time efficiency (total procedure time) Clinical indication: single crown, common-effect model Unresolved: the two extractors disagree on this row. | MD -4.31 [-4.43, -4.20] GRADE not reported 3 studies · 108 participants |
| Adults with full-arch implant restorations (subgroup of time efficiency analysis) | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Total procedure time (minutes) Indication: full arch | MD -8.29 [-17.95, 1.37] GRADE not reported 2 studies · 150 participants |
| Patients receiving implant-supported full-arch prostheses | Fully digital workflow (intraoral scanning) | Conventional workflow (elastomeric impression) | Time efficiency (total procedure time) Clinical indication: full arch, common-effect model Unresolved: the two extractors disagree on this row. | MD -8.23 [-9.53, -6.93] GRADE not reported 2 studies · 150 participants |
Included primary studies 18
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Beck 2024 Clinical and Radiographic Outcomes of Single Implant-Supported Zirconia Crowns Following a Digital and Conventional Workflow: Four-Year… DOI:10.3390/jcm13020432 | 2024 | this review only | Implant survival (implant failure); Marginal bone loss | not extracted yet |
| Beck 2024 Clinical and Radiographic Outcomes of Single Implant-Supported Zirconia Crowns Following a Digital and Conventional Workflow: Four-Year… PMID:38256565 | 2024 | this review only | Implant survival (implant failure) | not extracted yet |
| Capparè 2019 Conventional versus Digital Impressions for Full Arch Screw-Retained Maxillary Rehabilitations: A Randomized Clinical Trial DOI:10.3390/ijerph16050829 | 2019 | this review only | Total procedure time (minutes); Implant survival (implant failure); Marginal bone loss | not extracted yet |
| Capparè 2019 Conventional versus Digital Impressions for Full Arch Screw-Retained Maxillary Rehabilitations: A Randomized Clinical Trial. PMID:30866465 | 2019 | this review only | Total procedure time (minutes); Implant survival (implant failure) | not extracted yet |
| Chochlidakis 2020 Digital Versus Conventional Full‐Arch Implant Impressions: A Prospective Study on 16 Edentulous Maxillae DOI:10.1111/jopr.13162 | 2020 | this review only | not stated | not extracted yet |
| Chochlidakis 2020 Digital Versus Conventional Full-Arch Implant Impressions: A Prospective Study on 16 Edentulous Maxillae. PMID:32166793 | 2020 | this review only | not stated | not extracted yet |
| Corsalini 2024 Comparison between Conventional and Digital Workflow in Implant Prosthetic Rehabilitation: A Randomized Controlled Trial. PMID:38921523 | 2024 | this review only | Total procedure time (minutes); Patient-reported comfort and satisfaction (VAS 0-100) | not extracted yet |
| De Angelis 2023 Evaluation of Prosthetic Marginal Fit and Implant Survival Rates for Conventional and Digital Workflows in Full-Arch Immediate Loading… DOI:10.3390/jcm12103452 | 2023 | this review only | Total procedure time (minutes); Accuracy/fit (marginal fit or 3D deviation); Implant survival (implant failure); Marginal bone loss | not extracted yet |
| De Angelis 2023 Evaluation of Prosthetic Marginal Fit and Implant Survival Rates for Conventional and Digital Workflows in Full-Arch Immediate Loading… PMID:37240558 | 2023 | this review only | Total procedure time (minutes); Accuracy/fit (marginal fit or 3D deviation); Implant survival (implant failure) | not extracted yet |
| Delize 2019 Intrasubject comparison of digital vs. conventional workflow for screw‐retained single‐implant crowns: Prosthodontic and patient‐centered… DOI:10.1111/clr.13494 | 2019 | this review only | Patient-reported comfort and satisfaction (VAS 0-100) | not extracted yet |
| Delize 2019 Intrasubject comparison of digital vs. conventional workflow for screw-retained single-implant crowns: Prosthodontic and patient-centered… PMID:31183902 | 2019 | this review only | Patient-reported comfort and satisfaction (VAS 0-100) | not extracted yet |
| Gedrimiene 2019 Accuracy of digital and conventional dental implant impressions for fixed partial dentures: A comparative clinical study. PMID:31754417 | 2019 | this review only | Accuracy/fit (marginal fit or 3D deviation) | not extracted yet |
| Hashemi 2022 Fully Digital versus Conventional Workflows for Fabricating Posterior Three-Unit Implant-Supported Reconstructions: A Prospective… DOI:10.3390/ijerph191811456 | 2022 | this review only | Total procedure time (minutes); Accuracy/fit (marginal fit or 3D deviation); Patient-reported comfort and satisfaction (VAS 0-100); Implant survival (implant failure) | not extracted yet |
| Hashemi 2022 Fully Digital versus Conventional Workflows for Fabricating Posterior Three-Unit Implant-Supported Reconstructions: A Prospective… PMID:36141729 | 2022 | this review only | Total procedure time (minutes); Accuracy/fit (marginal fit or 3D deviation); Patient-reported comfort and satisfaction (VAS 0-100); Implant survival (implant failure) | not extracted yet |
| Joda & Brägger 2016 (patient-centered) Patient‐centered outcomes comparing digital and conventional implant impression procedures: a randomized crossover trial DOI:10.1111/clr.12600 | 2015 | this review only | Total procedure time (minutes); Patient-reported comfort and satisfaction (VAS 0-100) | not extracted yet |
| Joda & Brägger 2016 (time-efficiency) Time‐efficiency analysis of the treatment with monolithic implant crowns in a digital workflow: a randomized controlled trial DOI:10.1111/clr.12753 | 2016 | this review only | Total procedure time (minutes) | not extracted yet |
| Joda 2016 (PROMs) Patient-centered outcomes comparing digital and conventional implant impression procedures: a randomized crossover trial. PMID:25864771 | 2016 | this review only | Total procedure time (minutes); Patient-reported comfort and satisfaction (VAS 0-100) | not extracted yet |
| Joda 2016 (time) Time-efficiency analysis of the treatment with monolithic implant crowns in a digital workflow: a randomized controlled trial. PMID:27796072 | 2016 | this review only | Total procedure time (minutes) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Humans requiring implant-supported restorations (single crowns or full-arch) | Patients with implant-supported single crowns, 3-unit bridges and full-arch prostheses (n=10 studies) |
| Intervention | Fully digital workflow (intraoral scanning) | Intraoral scanning digital workflows (TRIOS, iTero, Carestream, True Definition) |
| Comparison | Conventional workflow (elastomeric impressions) | Polyether, PVS, silicone or gypsum conventional impressions |
| Outcomes | Passivity of fit, marginal adaptation, time efficiency, complication rates, PROMs; implant survival | Time efficiency (6 studies, 278); accuracy/fit (3, 120); PROMs (4, 172); implant survival (4, 202); marginal bone loss (3) |
| Study designs | RCTs and non-randomized prospective/retrospective clinical studies | 6 RCTs and 4 non-randomized studies |
| Timing | Not specified | Cross-sectional to 4 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | RCT: Yes · NRSI: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |